Project summary The mentored research project and training plan in this application will help Dr Joji Suzuki become an independent investigator to improve the treatment of patients with opioid use disorders (OUD) initially identified in general medical settings. This is an area of enormous public health concern because patients with OUDs frequently access general medical care, such as hospitals and emergency rooms, and are more likely to be readmitted following discharge. As such, general medical settings may be important venues in which to initiate treatment. However, very little is known about the optimal methods to initiate and retain patients in effective substance use disorder treatment during and after hospitalizations. To fill this unmet need, the proposed project will test the ISTOP intervention (Initiating Substance Use Disorder Treatment for Hospitalized Opioid Use Disorder Patients) targeting hospitalized OUD patients in a randomized clinical trial. The ISTOP intervention combines buprenorphine initiated in the hospital, a care manager in the hospital to address domains shown to reduce readmissions, and a recovery coach to work with participants in the community after discharge. The goal is to increase treatment retention, reduce illicit opioid use, and reduce readmissions. If the ISTOP intervention proves to be effective, it will lay the foundation for a future R01 application. Dr Suzuki will be mentored by a group of renowned researchers to achieve the following training goals: 1) obtain a mentored experience conducting a clinical trial for the treatment of OUD patients, 2) gain proficiency in conducting research that integrates pharmacologic and psychosocial treatments for OUD in the community setting, 3) develop skills in researching treatments for OUD initiated in general medical settings and continued into the community, and 4) develop greater understanding of quantitative methods needed for clinical research. These training goals will be met by a combination of close mentorship, formal coursework, seminars/workshops, and conference attendance. The training and research project will be overseen by a mentoring team composed of his primary mentor Dr Roger Weiss, an internationally recognized addiction researcher with considerable expertise in OUD; co-mentor Dr Jane Liebschutz, a researcher with expertise studying substance use disorders in medical settings; co-mentor Dr David Smelson, a researcher with considerable experience with community-based research including researching recovery coaches; co-mentor Dr Jeffrey Schnipper, a researcher with expertise studying health outcomes for hospitalized patients; and co-mentor Dr Robert Glynn, a researcher with extensive experience in designing and analyzing clinical trials. With access to a NIH-funded Clinical and Translational Science Center (Harvard Catalyst) and the career development support through Brigham and Women's Hospital and Harvard Medical School, Dr Suzuki is in an ideal academic environment to realize these trainings goals and to successfully complete the proposed project. The proposal is consistent with NIDA's strategic plan to develop successful treatments for OUD and improve treatment accessibility.